Reform Alert - News from the Blues' Office of National Health Reform

Final regulations released on Employer Shared Responsibility requirements for 2015 and beyond

Update to previous alert from July 26, 2013: IRS issues formal notice delaying employer mandate and coverage reporting until 2015

Feb. 12, 2014

On Feb. 10, 2014, the Treasury Department and the Internal Revenue Service released final regulations for the Employer Shared Responsibility provisions (also referred to as the employer mandate) under the Affordable Care Act. These final regulations provide additional transition relief to employers and clarify or confirm guidance that was previously issued.

In general, the employer mandate applies to applicable large employers with 50 or more full-time equivalent employees. However, there is a transition period that will phase in this requirement.

  • Starting on Jan. 1, 2015, the employer mandate will apply to applicable large employers with 100 or more full-time equivalent employees. In 2015, the mandated requirements will not apply to employers with fewer than 100 full-time equivalent employees.
  • In 2016, the employer shared responsibility provisions will apply to employers with 50 or more full-time equivalent employees.

Is there a phase-in period for the number of employees that must be covered to avoid an assessable payment?

Yes. In 2015, an applicable large employer potentially will be subject to a penalty if it does not cover at least 70 percent of its full-time equivalent employees.

In 2016, applicable large employers will be required to cover at least 95 percent of their full-time employees.

Is there a safe harbor for the requirement that employers offer coverage to employees’ dependents?

Yes. Employers that currently do not offer coverage to dependents (and did not offer coverage to dependents in 2013) are generally permitted to transition to offering such coverage in 2016.

When are these requirements effective?

Generally, the requirements are effective beginning on Jan. 1, 2015. For those applicable large employers with non-calendar plan years that begin after Jan. 1, 2015, the final rule includes a safe harbor that generally will make the mandate effective beginning with the first day of their 2015 plan year.

These provisions require that any applicable large employer that, for a calendar month, does not offer its full-time employees health coverage that is affordable and provides minimum value may be subject to the assessable payments (tax penalty) if a full-time employee enrolls for that month in a qualified health plan (QHP) through an Exchange and receives a premium tax credit.

These requirements were originally effective beginning Jan. 1, 2014, but in July 2013, the assessable payments were delayed by one year.

More information can be found at:

The information in this document is based on preliminary review of the national health care reform legislation and is not intended to impart legal advice. The federal government continues to issue guidance on how the provisions of national health reform should be interpreted and applied. The impact of these reforms on individual situations may vary. This overview is intended as an educational tool only and does not replace a more rigorous review of the law's applicability to individual circumstances and attendant legal counsel and should not be relied upon as legal or compliance advice. As required by US Treasury Regulations, we also inform you that any tax information contained in this communication is not intended to be used and cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.

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